Methods and devices for controlled flexion restriction of spinal segments
View Patent ↗A system for restricting spinal flexion includes superior and inferior tether structures joined by a pair of compliance members. Compliance members comprise tension members which apply a relatively low elastic tension on the tether structures. By placing the tether structures on or over adjacent spinous processes, flexion of a spinal segment can be controlled in order to reduce pain.
1. A method for restricting flexion of at least one spinal segment, said method comprising:
implanting a constraining structure having a superior end coupled to a superior spinous process and an inferior end coupled to an inferior spinous process or a sacrum, wherein the constraining structure has an undeformed position and implanting comprises placing a superior tether structure over or through the superior spinous process and placing an inferior tether structure over or through the inferior spinous process or sacrum, wherein the tether structures are substantially non-distensible and joined by at least one compliance member which provides an elastic resistance to flexion; wherein the constraining structure provides the elastic resistance to flexion beyond a neutral position of the spinal segment in the range from 7.5 N/mm to 20 N/mm wherein the constraining structure elastically recovers its undeformed position when the spinal segment returns to its neutral position; and wherein the tethers of the constraining structure will experience a creep below 10% after one million cycles at typical physiologic loads.
2. A method as in claim 1 , wherein the constraining structure provides a resistance to extension beyond the neutral position of the spinal segment below 3 N/mm.
3. A method as in claim 2 , wherein the resistance to extension is below 0.5 N/mm.
4. A method as in claim 1 , wherein the tether structures are joined by at least two compliance members which are placed on the right and left sides of a midline of the spinal segment.
5. A method as in claim 1 , wherein the constraining structure is tightened over the spinous processes to apply a force to the spinous processes in the range from 1N to 25N before flexion while the spinal segment remains at a neutral position.
6. A method as in claim 1 , wherein the constraining structure is pre-tensioned to provide an initial static resistance in the range from 5N to 25N which must be overcome before initiating deformation.
7. A method as in claim 1 , wherein the creep is below 5%.
8. A method as in claim 7 , wherein the creep is below 1%.